Description: Alteration of the participant’s food intake for the purpose of changing behavior. Many diets involve eliminating substances from the participant’s food intake.
Examples: Gluten-Free (wheat), Casein-Free (dairy), Sugar Free, Removal of food dyes, Foods thought to produce maladaptive behavior
Research Summary: One well-designed but small study on the gluten-free casein-free diet found no improvement in cognitive, language, or motor skills with the diet; however, there may have been a reduction in autistic behaviors such as repetitive statements (Knivsberg, Reichelt, Hoien, & Nodland, 2002). A second well-designed but small study found no evidence of benefit (Elder et al., 2006).
Additional study of the theoretical basis and efficacy of the GfCf diet is warranted (Millward, Ferriter, Calver, & Connell-Jones, 2004). There is a risk that removing gluten and casein from an individual’s diet will lead to inadequate nutrition, therefore, dietary counseling is important for families who place their children on the diet (Hyman & Levy, 2003).
There are no scientific studies on other dietary interventions for children with autism spectrum disorders.
Recommendations: An important area for research is to conduct studies with strong scientific designs to evaluate the GfCf diet and other dietary interventions for individuals with autism spectrum disorders. Professionals should present diets as untested as a treatment for autism spectrum disorders, recommend dietary counseling to ensure adequate nutritional intake, and encourage families who are considering this intervention to evaluate its effects and side-effects carefully.
Selected scientific studies:
Hyman, S. L., Stewart, P. A., Foley, J., Peck, R., Morris, D. D., Wang, H., & Smith, T. (2016). The gluten-free/casein-free diet: a double-blind challenge trial in children with autism. Journal of Autism and Developmental Disorders, 46(1), 205-220. 205–220. doi: 10.1007/s10803-015-2564-9
Williams, K.E. and Foxx, R.M. The Gluten-Free, Casein-Free Diet. In R. M. Foxx & J. A. Mulick (Eds.) (2016). Controversial Therapies for Autism and Intellectual Disabilities: Fads, Fashion and Science in Professional Practice. (pp. 410-421). New York, NY: Routledge.
Millward, C., Ferriter, M., Calver, S., & Connell-Jones, G. (2008). Gluten- and casein-free diets for autistic spectrum disorder. The Cochrane Database of Systematic Reviews, 2. doi: 10.1002/14651858.CD003498.pub3
Elder, J. H., Shankar, M., Shuster, J., Theriaque, D., Burns, S., & Sherrill, L. (2006). The gluten-free, casein-free diet in autism: Results of a preliminary double blind clinical trial. Journal of Autism and Developmental Disorders. www.springerlink.com
Systematic reviews of scientific studies:
Levy, S. E., & Hyman, S. L. (2003). Use of complementary and alternative treatments for children with autism spectrum disorders is increasing. Pediatric Annals, 32, 685-691.
Knivsberg, A-M., Reichelt, K. L., Hoien, T., & Nodland, M. (2002). A randomised, controlled study of dietary intervention in autistic syndromes. Nutritional Neuroscience, 5, 251-261.